Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Dagim Desta, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1366024978

Dr. Dagim Desta, MD is a Hospitalist in Staten Island, New York. Qualified in 2003, 23 years ago. Practices with Wellstar Medical Group LLC, a 3,072-clinician group. Licensed in Georgia.

Years since qualifying
23
Licensed in
GA
In the registry since
2021
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

355 Bard Ave Dept OF Medicine Villa Bldg 1ST Fl
Staten Island, NY 10310
Phone: (718) 818-2419
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 102742 (GA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1366024978
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 22, 2021
Last updated in NPPESDecember 24, 2024
Certification dateDecember 24, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyHOSPITALIST
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Wellstar Medical Group Llc — 3072 clinicians
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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